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Tuesday, July 4, 2006

M.I.B. (NOT Smith & Jones)

Conventional wisdom ("common knowledge") is interesting, fun, and most often, wrong. What prompts me to make this observation is an email I recently received:
"I was very surprised with a little known fact concerning the Medical Insurance Board (MIB). Do consumers really understand the ramifications of their medical history in this system?"
Apparently, my correspondent has had some recent troubles obtaining health insurance. I'm still not sure what, exactly, the missive's author wants from me; I replied, of course, and am waiting for more information.
In the meantime, it may be useful to bust a few myths about what the Medical Information Bureau really is, and what it really does:
First, the MIB does not keep a copy of one's medical records. One doesn't really even need to read the FAQ on their website to know this; it just doesn't pass the "smell test." Think about it: even before the draconian privacy measures mandated by HIPAA (which, we'll grant, aren't exactly enthusiatically enforced), how would such an organization go about getting all the files from all the doc's that one has ever seen? And where in the Wide, Wide World of Sports would they keep them?
Second, only folks who have applied for insurance (life or health) from one of the 600 companies who participate are even subject to its "review" (IIRC, there are something like 1,800 such carriers). And of these, the Bureau is informed regarding only those who have been rated or declined. Then, if such a person applies for another policy, with another participating carrier, will it even matter?
Third, these notes are kept for a maximum of seven years, after which they are purged. So it's not "forever," anyway.
It is true that most (if not all) life and health applications (and to be accurate, I'm lumping in Disability and Long Term Care policies under the general heading of Life and Health) include a question regarding previous insurance experiences. That is, they ask if one has ever been rated or declined for insurance. Some carriers give this question (and its implications) greater weight than others; conversely, some carriers are notoriously stringent in their underwriting process, and that has a certain significance, as well.
The primary mission of the M.I.B. is "to detect and deter attempts by applicants of life, health, disability, or long-term insurance who would omit or misrepresent facts." This is actually a powerful tool for us consumers: fraud helps drive up the cost of insurance (as if it needed any help to get more expensive). By working to minimize it, organizations like the M.I.B. help to hold down those increases.
While I take each email (and, for that matter, each comment) seriously, I think that sometimes folks let their imaginations run a bit wild. It may well be that this person has had a bad experience, and I will try my best to help resolve it. But the M.I.B. isn't the enemy.

Old Fashioned Medicine

When Dr Crippen was a little boy, medically speaking, the treatment of high blood pressure was straightforward. Relatively. You started with either a beta blocker or a mild diuretic (depending on age) and if you needed more, you added a vasodilator.

Was this all wrong? What has changed?


I too have wondered the same. I also maintain we have become a society that is over-reliant on meds that do little more than address symptoms and do nothing to treat the underlying problem.

The first commonly available beta blocker was propranolol. Note the “olol” ending. Now we have atenolol, metoprolol, bisoprolol, sotalol and so on. Cimetidine was a new drug for ulcer treatment; then along came ranitidine with a huge advertising budget and supplanted cimetidine. Omeprazole, another “ulcer drug”, was soon joined by lansoprazole and esomeprazole.

The original drugs, such as propranolol, are long out of patent. Anyone can make them and anyone does. They cost a few pence a month. The profit has gone for Big Pharma. There is nothing to be gained from flying doctors to Acapulco to discuss propranolol.


I have heard similar complaints about sulfa drugs. At one time they were widely used to treat infection. Once antibiotics came along the sulfa drugs were no longer used. Now we have new, antibiotic-resistant strains. Should we return to some of the "old" remedies to combat new illness?

Monday, July 3, 2006

Darned if you do, or don’t...

Recently, my mother was hospitalized for a week, the victim of a prolonged headache that just wouldn’t quit. Turned out to be an inflammation of an artery, and not (as feared) something worse, such as a tumor.
In many such cases, folks start thinking about their own (and/or their parents’) long-term prospects, and the thought of Long Term Care eventually surfaces. Thankfully, Mom’s condition is (relatively) easy to treat, and she should be fine soon. ‘Course, I am concerned that she found the hospital food superior to her own home cookin’, but that’s a discussion for another day.
All of this by way of introduction to an interesting, if disheartening, study undertaken by the John Hancock (okay, you purists will have noted that I used “the,” a throwback to “the old days.” I also put an “e” at the end of envelope, and spell dilemna with an “n.”), which shows a startling disconnect between what we know to be true, and how we choose to deal with the truth.
To wit: even though we know about the graying of our population, and we know that health care costs keep escalating, we choose to ignore the connection. According to the JH study “Americans are less worried today than they were roughly a decade ago about needing and paying for LTC.” This is stupid. We know that gas prices have risen, and we grumble about those. We know that mortgage rates are on the rise, and we worry about that. But we can choose a smaller house, or a more fuel-efficient vehicle; what is the alternative to living longer?
I know, trick question.
Here's what's weird: while over half of those surveyed were concerned about the cost of care, that's still a 12 point drop from folks 10 years ago. On top of that, compared with the '97 study, fewer people were concerned that they'd even need long term care.
OTOH, almost 2/3 of the respondents thought they'd make it to (at least) 85, and that the cost of LTC would have a substantial (and negative) impact on the post-retirement financial position. This concern, by the way, is an increase over the old study.
And so, we have a population that is ageing, that believes that it will get even older, that believes that there is a greater likelihood that they'll need more (and more expensive) care, and yet aren't really worried all that much about it.
I have a picture in mind.
Something else I found interesting is that, after a decade of sales pitches, advertisements, promotions, news articles and studies, most of those surveyed had no more knowledge about the nature and cost of long term care than their counterparts did 10 years ago. That’s a bit scary, no?

Sunday, July 2, 2006

Cavalcade of Risk Reminder

Submissions for the upcoming C of R are due by tomorrow (Monday the 3rd). Submitting a post is easy:
■ Via email
■ at the Blog Carnival
or
■ at Ferdy's
Don't forget, if you've seen a relevant post at another blog, feel free to submit it, as well. If you have any questions, stop by the C of R home page, or drop us a line here.
Have a great (and safe) 4th of July!

Insurance Dispatch

My latest column is up at The Medical Blog Network. We look at how cat claims are paid under both Co-Pay and High Deductible plans.

Comments welcome!

Saturday, July 1, 2006

Book Ahead

Quebecers hoping to be screened for colon cancer are facing up to a year-long wait for diagnostic tests that could save their lives.

That's unacceptable, Barry Stein, head of the Colorectal Cancer Association of Canada, said yesterday.

"You can't just walk in the door and get a colonoscopy. Why? Not enough (specialists), not enough equipment," Stein said.

Quebecers aren't alone. Canadians attempting to follow their family doctor's advice to get a colonoscopy at age 50 are having trouble booking a specialist
.

Make a note of things to do on your 49th birthday. Call ahead for a colonoscopy . . .

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